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‣ A Graphical Representation Model for Telemedicine and Telehealth Center Sustainability

Gundim, Rosangela Simoes; Wen, Chao Lung
Fonte: MARY ANN LIEBERT INC Publicador: MARY ANN LIEBERT INC
Tipo: Artigo de Revista Científica
Português
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This study shows the creation of a graphical representation after the application of a questionnaire to evaluate the indicative factors of a sustainable telemedicine and telehealth center in Sao Paulo, Brazil. We categorized the factors into seven domain areas: institutional, functional, economic-financial, renewal, academic-scientific, partnerships, and social welfare, which were plotted into a graphical representation. The developed graph was shown to be useful when used in the same institution over a long period and complemented with secondary information from publications, archives, and administrative documents to support the numerical indicators. Its use may contribute toward monitoring the factors that define telemedicine and telehealth center sustainability. When systematically applied, it may also be useful for identifying the specific characteristics of the telemedicine and telehealth center, to support its organizational development.

‣ Telemedicina : análise da sua evolução no Brasil; Telemedicine: analysis of its evolution in Brazil.

Khouri, Sumaia Georges El
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 19/08/2003 Português
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O presente estudo consiste em descrever e analisar a evolução da Telemedicina no Brasil, abrangendo as experiências efetivamente implantadas até dezembro de 2000. Várias instituições no país têm adotado programas de telemedicina, tais como hospitais, laboratórios de análises clínicas, clínicas especializadas em realização de eletrocardiogramas à distância, universidades, o Exército e o próprio Governo. Cada uma das experiências tem diferentes objetivos e não há nenhuma integração entre elas. As aplicações estudadas variam desde aquelas que requerem uma estrutura tecnológica simples como a realização de eletrocardiogramas à distância, até outras mais sofisticadas tecnologicamente como a realização de teleconferências com transmissão de imagens clínicas para segunda opinião médica e monitoração remota de leitos. Para a realização do estudo foram feitas entrevistas com os responsáveis pelos programas e um levantamento de dados em publicações especializadas. As conclusões apontam para a falta de coordenação entre os modelos adotados, para a resistência cultural relativa à informática médica e à telemedicina e para o papel tímido do Governo no fomento da telemedicina.; The present study consists in describing and analyzing the evolution of Telemedicine in Brazil...

‣ Gestão dos fatores determinantes para sustentabilidade de Centros de Telemedicina; Management of determinant factors for the sustainability of the telemedicine centers

Gundim, Rosângela Simões
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 23/09/2009 Português
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Este estudo trata do desenvolvimento e aplicação de um instrumento de gestão dos fatores indicadores de sustentabilidade de centros de telemedicina e telessaúde. Com base em referencial teórico da administração e na experiência profissional da pesquisadora foram elencadas inicialmente 36 perguntas, categorizadas em 7 áreas de domínio, para avaliação de concordância com 04 pessoas com experiência em telemedicina. As categorias de domínio foram: Institucional, Relacional, Funcional, Econômico-Financeira, Renovação, Técnica-Científica e Bem-Estar Social, que compuseram o roteiro semiestruturado para entrevistas qualitativas individuais de avaliação de desempenho com 10 centros de telemedicina e telessaúde brasileiros, originários das regiões sul, sudeste, norte, nordeste e centro-oeste. As entrevistas foram realizadas em dois momentos distintos, com um intervalo de tempo em torno de 12 meses. Em ambos os momentos foi aplicado o mesmo roteiro aos mesmos entrevistados com o ano de 2007 como períodos de referência de avaliação. As respostas das perguntas de cada centro foram convertidas em valores numéricos. Depois foram apresentados graficamente em forma de um polígono, que tinham morfologia e área própria. Não foi possível comparar os polígonos de um centro com outro. Foi feita a avaliação das diferenças das pontuações das categorias de perguntas entre as 2 entrevistas. Verificou-se que as pontuações nas avaliações feitas na 2ª entrevista foram menores que as da primeira. A esta diferença...

‣ Atendimento ao trauma de face por telemedicina. Validação de modelo de videoconferência com uso de smartphone e análise da concorância com atendimento presencial; Facial trauma assessment through telemedicine. Validation of a videoconference via smartphones model and analysis of agreement between telemedicine and face-to-face attending

Fonseca, Alexandre Siqueira Franco
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 13/05/2014 Português
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As dimensões continentais de alguns países e a distribuição heterogênea da rede hospitalar dificultam o acesso ao atendimento inicial adequado ao trauma de face principalmente aos pacientes residentes em regiões mais remotas. Um modelo de atendimento por telemedicina pode ser uma opção ao atendimento especializado presencial. Os objetivos deste trabalho são apresentar um modelo de atendimento por especialistas à distância, por meio de videoconferência utilizando-se smartphone, e analisar a concordância deste atendimento por telemedicina com o atendimento presencial, considerado padrão ouro. Cinquenta pacientes com trauma de face e suspeita de fratura de face (n=50) foram atendidos, por duas equipes independentes, uma presencialmente e outra por telemedicina. A equipe presencial, que era formada pela equipe de plantão de cirurgia plástica na unidade de emergência, prestou o atendimento à beira do leito (história, exame físico e análise de imagens por tomografia computadorizada). A equipe telemedicina, composta por um médico generalista atendendo à beira do leito, prestou atendimento em conjunto com um cirurgião plástico à distância através de videoconferência com um smartphone. Após cada atendimento as duas equipes responderam a um questionário...

‣ API de DICOM para sistemas de telemedicina de eletrocardiografia; A DICOM API for electrocardiography telemedicine systems

Petry, Tobias Brignol
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Trabalho de Conclusão de Curso Formato: application/pdf
Português
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As doenças do coração estão atualmente entre as maiores causas de morte no mundo. O exame de eletrocardiograma é um procedimento simples e não invasivo que permite detectar anomalias no funcionamento do coração de um paciente. A possibilidade de manter, em uma mesma base de dados, o histórico de eletrocardiogramas do paciente, independente do equipamento em que eles foram realizados, facilita o acompanhamento médico e o diagnóstico de enfermidades. Este trabalho apresenta uma análise do modelo de um eletrocardiograma e do padrão de exames médicos DICOM. Com base nesta análise, se realizou o projeto de desenvolvimento de uma API que permite a conversão de exames realizados em dois aparelhos, com protocolos diferentes, para o formato de arquivo do DICOM. A API pode ser usada também para a leitura de arquivos neste formato, de forma a permitir o armazenamento destes exames em um banco de dados. A aplicação desenvolvida foi testada utilizando um visualizador conhecido de formas de onda em DICOM, dois aparelhos eletrocardiógrafos, e um sistema de telemedicina com armazenamento de exames em um servidor central.; Heart diseases are among the world’s leading causes of death nowadays. An electrocardiogram is a simple, non-invasive procedure that can unveil a patient’s heart condition. Storing a patient’s history of electrocardiograms in a single database...

‣ Non-adherence to telemedicine interventions for drug users: systematic review

Moreira,Taís de Campos; Signor,Luciana; Figueiró,Luciana Rizzieri; Fernandes,Simone; Bortolon,Cassandra Borges; Benchaya,Mariana Canellas; Ferigolo,Maristela; Barros,Helena MT
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 Português
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OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably...

‣ Feasibility of a Clearing House for Improved Cooperation Between Telemedicine Networks Delivering Humanitarian Services: Acceptability to Network Coordinators

Wootton, Richard; Bonnardot, Laurent; Geissbuhler, Antoine; Kovarik, Carrie; McGoey, Suzanne; Person, Donald A.; Vladzymyrskyy, Anton; Zolfo, Maria; Jethwani, Kamal Shanker
Fonte: Co-Action Publishing Publicador: Co-Action Publishing
Tipo: Artigo de Revista Científica
Português
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Background: Telemedicine networks, which deliver humanitarian services, sometimes need to share expertise to find particular experts in other networks. It has been suggested that a mechanism for sharing expertise between networks (a ‘clearing house’) might be useful. Objective: To propose a mechanism for implementing the clearing house concept for sharing expertise, and to confirm its feasibility in terms of acceptability to the relevant networks. Design We conducted a needs analysis among eight telemedicine networks delivering humanitarian services. A small proportion of consultations (5–10%) suggested that networks may experience difficulties in finding the right specialists from within their own resources. With the assistance of key stakeholders, many of whom were network coordinators, various methods of implementing a clearing house were considered. One simple solution is to establish a central database holding information about consultants who have agreed to provide help to other networks; this database could be made available to network coordinators who need a specialist when none was available in their own network. Results: The proposed solution was examined in a desktop simulation exercise, which confirmed its feasibility and probable value. Conclusion: This analysis informs full-scale implementation of a clearing house...

‣ Tailoring software process capability/maturity models for telemedicine systems

Gresse von Wangenheim, Christiane; von Wangenheim, Aldo; Hauck, Jean Carlo R.; Mc Caffery, Fergal; Buglione, Luigi
Fonte: University of Limerick Publicador: University of Limerick
Tipo: info:eu-repo/semantics/conferenceObject; all_ul_research; ul_published_reviewed
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peer-reviewed; Developing high-quality asynchronous store-and-forward telemedicine systems (ASFTSs) remains a challenge. However, there is no accepted understanding as to what are the important quality characteristics for this type of software system and/or what defines a mature software process for producing high-quality ASTFSs. Through adopting a multi-step research methodology, we define a quality model for ASFTSs indicating relevant quality characteristics and their priority for this specific type of software system based upon ISO/IEC 25010. We, then, propose an extended software process capability/maturity model based on ISO/IEC 15504 and ISO/IEC 12207 to meet these particular quality requirements. The resulting model can be used to both guide the development and the evaluation of such systems. We expect that the availability of such a customized model will facilitate the development of high-quality ASFTSs, reducing related risks and improving the quality of telemedicine services.

‣ Cost savings from a telemedicine model of care in northern Queensland, Australia

Thaker, D.; Monypenny, R.; Olver, I.; Sabesan, S.
Fonte: Australasian Med Publ Co Ltd Publicador: Australasian Med Publ Co Ltd
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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OBJECTIVE: To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services. DESIGN: Retrospective cost–savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings. PARTICIPANTS AND SETTING: Records of all patients managed by means of teleoncology at the Townsville Cancer Centre (TCC) and its six rural satellite centres in northern Queensland, Australia between 1 March 2007 and 30 November 2011. MAIN OUTCOME MEASURES: Costs for set-up and staffing to manage the service, and savings from avoidance of travel expenses for specialist oncologists, patients and their escorts, and for aeromedical retrievals. RESULTS: There were 605 teleoncology consultations with 147 patients over 56 months, at a total cost of $442 276. The cost for project establishment was $36 000, equipment/maintenance was $143 271, and staff was $261 520. The estimated travel expense avoided was $762 394; this figure included the costs of travel for patients and escorts of $658 760, aeromedical retrievals of $52 400 and travel for specialists of $47 634...

‣ Sichere Echtzeitübertragung in der Medizin-Telematik; Secure Real-Time Transmission in Telemedicine

Kamphenkel, Kai
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
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Ziel der Arbeit ist die Analyse von Telemedizin-Szenarien und die Entwicklung neuer technischer Ansätze zur Realisierung von sicherer Echtzeitübertragung in der Medizin. In der im Vorfeld stattgefundenen Untersuchung am Universitätsklinikum in Tübingen hat sich das erweiterte Notfallszenario in Form der Expertenkonsultation unter Verwendung von präklinischer Sonographie als besonders interessant und technisch anspruchsvoll herausgestellt. Neben der technischen Umsetzung gilt es, auch die Integration in bestehende medizinische Workflows zu realisieren. Für den technischen Bereich hat sich herausgestellt, dass eine auf adaptiven Algorithmen beruhende Komponente, das Intelligente Netz (IN), in der Lage ist, einen performanten parallelen Datentransfer zu realisieren. In einem Multipfad-SCTP-Szenario (MP-SCTP) wird die Multihoming-Eigenschaft des Stream Control Transmission Protocols (SCTP) genutzt, um Datenchunks auf verschiedene Ende-zu-Ende-Pfade zu verteilen. SCTP nutzt ursprünglich nur einen Pfad (den Primärpfad) für den Datentransfer, die weiteren Sekundärpfade werden hauptsächlich zur Ausfallsicherung verwendet. Die hieraus resultierenden technischen Probleme sind in der Literatur bereits umfangreich untersucht und größtenteils gelöst worden. Die vorliegende Arbeit fokussiert auf die Pfadwahl in einem heterogenen Netzwerk...

‣ Telemedicine experience for chronic care in COPD

Toledo, Paula de; Jiménez-Fernández, Silvia; Pozo-Guerrero, Francisco del; Roca, Josep; Alonso, Albert; Hernández, Carmen
Fonte: IEEE Engineering in Medicine and Biology Society; IEEE Computer Society [Technical Co-Sponsor] Publicador: IEEE Engineering in Medicine and Biology Society; IEEE Computer Society [Technical Co-Sponsor]
Tipo: info:eu-repo/semantics/acceptedVersion; info:eu-repo/semantics/article Formato: text/plain; application/pdf
Publicado em /07/2006 Português
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Information and telecommunication technologies are called to play a major role in the changes that healthcare systems have to face to cope with chronic disease. This paper reports a telemedicine experience for the home care of chronic patients suffering from chronic obstructive pulmonary disease (COPD) and an integrated system designed to carry out this experience. To determine the impact on health, the chronic care telemedicine system was used during one year (2002) with 157 COPD patients in a clinical experiment; endpoints were readmissions and mortality. Patients in the intervention group were followed up at their homes and could contact the care team at any time through the call center. The care team shared a unique electronic chronic patient record (ECPR) accessible through the web-based patient management module or the home visit units. Results suggest that integrated home telemedicine services can support health professionals caring for patients with chronic disease, and improve their health.We have found that simple telemedicine services (ubiquitous access to ECPR, ECPR shared by care team, accessibility to case manager, problem reporting integrated in ECPR) can increase the number of patients that were not readmitted (51% intervention...

‣ Technology and economic assessment of telemedicine : an example of DoD MEDNET in region three

Buker, Kirk Lorne
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado
Português
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Approved for public release; distribution is unlimited; The Department of Defense (DoD) has numerous initiatives underway to improve the health care delivery system within the military. Telemedicine is one of these initiatives that combine images, videos, sounds, and text to enhance the health care providers' ability to diagnosis and treat patients. The Secretary of the Army in October 1994 established, "The Center for Total Access" as a laboratory for healthcare re-engineering in the military. This thesis is provided as a resource guide to inform those who may become involved with this complex and chaotic field of telemedicine by providing a review of state-of-the- art technology that can support delivery of telemedicine, and by proposing a cost benefit framework for telemedicine configuration design. The material for this thesis was primarily researched utilizing Internet web browsing technologies. A review of the Tri-Service Infrastructure Management Program Office (TIMPO) project (MEDNET) is outlined as working example of a large regional telemedicine I telehealth system which was found to be the most revealing in the study of telemedicine.; http://archive.org/details/technologyeconom00buke; Lieutenant, United States Navy Reserve

‣ The impact of telemedicine interventions involving routine transmission of blood glucose data with clinician feedback on metabolic control in youth with type 1 diabetes: a systematic review and meta-analysis

Shulman, Rayzel M; O'Gorman, Clodagh S; Palmert, Mark R
Fonte: BioMed Central Ltd Publicador: BioMed Central Ltd
Tipo: info:eu-repo/semantics/article; all_ul_research; ul_published_reviewed
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peer-reviewed; Intensive glycemic control delays and preventsmicrovascular andmacrovascular complications of type 1 diabetes (T1DM) [1, 2]. Despite advances in insulin preparations and delivery mechanisms for insulin, glycemic control for many pediatric patients with T1DM remains suboptimal. An international study comparing glycemic control among pediatric diabetes centres failed to show a correlation with insulin regimen, suggesting that other factors, such as the organization of delivery of care and the number of staff on the diabetes team, may be critical to attaining optimal blood glucose control [3]. The intensive treatment protocol used in the Diabetes Control and Complications Trial (DCCT) included telephone contacts to adjust insulin regimens daily for the first week and then weekly thereafter. The intervention also involved an intensive insulin regimen, increased frequency of clinic visits, and intensive blood glucose monitoring [4]. Although shown to be effective in improving glycemic control, these intensive measures are not feasible to carry out in routine practice. Moreover, the particular challenges presented by youth with T1DM necessitate innovative management strategies [5]. One strategy for improving glycemic control is the use of telemedicine (TM). We distinguish routine T1DM management that may include solicited remote communication between patients and the diabetes team on an as-needed basis from TM interventions as defined in our study. We define TM to be the scheduled remote transmission of blood glucose (BG) data by means such as telephone...

‣ Initial experience at a university teaching hospital from using telemedicine to promote education through video conferencing

Tavares Pereira, Bruno Monteiro; Araujo Calderan, Thiago Rodrigues; Nolasco da Silva, Marcos Tadeu; da Silva, Antonio Carlos; Marttos, Antonio Carlos, Jr.; Fraga, Gustavo Pereira
Fonte: Associacao Paulista Medicina; Sao Paulo Publicador: Associacao Paulista Medicina; Sao Paulo
Tipo: Artigo de Revista Científica
Português
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CONTEXT AND OBJECTIVE: Telehealth and telemedicine services are advancing rapidly, with an increasing spectrum of information and communication technologies that can be applied broadly to the population's health, and to medical education. The aim here was to report our institution's experience from 100 videoconferencing meetings between five different countries in the Americas over a one-year period. DESIGN AND SETTING: Retrospective study at Universidade Estadual de Campinas. METHODS: Through a Microsoft Excel database, all conferences in all specialties held at our institution from September 2009 to August 2010 were analyzed retrospectively. RESULTS: A total of 647 students, physicians and professors participated in telemedicine meetings. A monthly mean of 8.3 (+/- 4.3) teleconferences were held over the analysis period. Excluding holidays and the month of inaugurating the telemedicine theatre, our teleconference rate reached a mean of 10.3 (+/- 2.7), or two teleconferences a week, on average. Trauma surgery and meetings on patient safety were by far the most common subjects discussed in our teleconference meetings, accounting for 22% and 21% of the total calls. CONCLUSION: Our experience with telemedicine meetings has increased students' interest; helped our institution to follow and discuss protocols that are already accepted worldwide; and stimulated professors to promote telemedicine-related research in their own specialties and keep up-to-date. These high-technology meetings have shortened distances in our vast country...

‣ Initial experience at a university teaching hospital from using telemedicine to promote education through video conferencing

Pereira,Bruno Monteiro Tavares; Calderan,Thiago Rodrigues Araújo; Silva,Marcos Tadeu Nolasco da; Silva,Antonio Carlos da; Marttos Jr,Antonio Carlos; Fraga,Gustavo Pereira
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 Português
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CONTEXT AND OBJECTIVE: Telehealth and telemedicine services are advancing rapidly, with an increasing spectrum of information and communication technologies that can be applied broadly to the population's health, and to medical education. The aim here was to report our institution's experience from 100 videoconferencing meetings between five different countries in the Americas over a one-year period. DESIGN AND SETTING: Retrospective study at Universidade Estadual de Campinas. METHODS: Through a Microsoft Excel database, all conferences in all specialties held at our institution from September 2009 to August 2010 were analyzed retrospectively. RESULTS: A total of 647 students, physicians and professors participated in telemedicine meetings. A monthly mean of 8.3 (± 4.3) teleconferences were held over the analysis period. Excluding holidays and the month of inaugurating the telemedicine theatre, our teleconference rate reached a mean of 10.3 (± 2.7), or two teleconferences a week, on average. Trauma surgery and meetings on patient safety were by far the most common subjects discussed in our teleconference meetings, accounting for 22% and 21% of the total calls. CONCLUSION: Our experience with telemedicine meetings has increased students' interest; helped our institution to follow and discuss protocols that are already accepted worldwide; and stimulated professors to promote telemedicine-related research in their own specialties and keep up-to-date. These high-technology meetings have shortened distances in our vast country...

‣ Should I Stay or Should I Go Now? (To the Hospital): Modeling the Impact of Introducing a Telemedicine System in a Remote Amazonian Community

Say, Rollin K
Fonte: Universidade Duke Publicador: Universidade Duke
Publicado em 18/04/2011 Português
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The health needs of rural and remote populations are often not fully addressed as health care professionals agglomerate in urban areas. Telemedicine utilizes modern telecommunications technology to extend health care resources to these populations, overcoming obstacles of time and space. Thus far, scholarly literature on the impact of telemedicine has been limited to weakly persuasive empirical evaluations of specific interventions. This paper constructs an economic model of the introduction of a telemedicine system to a remote Amazonian community. It finds that patients do not seek health care if the quality of care available in the village is below a threshold value, as the opportunity cost of receiving care outweighs its health benefits. This implies that government investments should only target health if this threshold value can be met.; Honors thesis

‣ Mobile telemedicine sensor networks with low-energy data query and network lifetime considerations

Hu, Fei; Wang, Yu; Wu, Hongyi
Fonte: Institute of Electrical and Electronics Engineers Publicador: Institute of Electrical and Electronics Engineers
Tipo: Postprint
Português
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In this paper, we use an integrated architecture that takes advantage of the low cost mobile sensor networks and 3G cellular networks to accommodate multimedia medical calls with differentiated Quality-of-Service (QoS) requirements. We propose a lowenergy, distributed, and concentric-zone-based data query mechanism that takes advantages of hierarchical ad hoc routing algorithms to enable a medical specialist to collect physiological data from mobile and/or remote patients. The medical specialist uses cellular network to report patients’ data to the medical center. Moreover, we propose a transmission scheme among different zones with balance-based energy efficiency, which can extend network lifetime. We evaluate the validity of our proposals through simulations and analyze their performance. Our results clearly indicate the energy efficiency of the proposed sensor network query algorithms and the efficiency of our multiclass medical call admission control scheme in terms of meeting the multimedia telemedicine QoS requirements.

‣ Telemedicine application at the University of Rochester Medical Center Strong Memorial Hospital in conjunction with the New York State Department of Corrections

Christensen, Jeannine
Fonte: Rochester Instituto de Tecnologia Publicador: Rochester Instituto de Tecnologia
Tipo: Tese de Doutorado
Português
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Telemedicine has been around for several years and it is inevitable that this technology will shape the current healthcare environment. Doctors are often faced with the challenges of the laws of time and distance. With the presence of telemedicine, the idea of having access to a physician at any given time becomes a reality. This paper will present an exciting concept of telemedicine for today and tomorrow with an emphasis on the advancement of health care delivery systems. This thesis will also attempt to present the cost saving factors that telemedicine can provide not only to patient care but also to the financial and administrative aspects of healthcare. It will provide a summation of goals, design description and the initial cost of implementing a telemedicine application. This paper will be a combination of discussions on general telemedicine applications and a practical implementation. It culminated with a presentation of an actual telemedicine project that the University of Rochester Medical Center implemented in conjunction with the New York State Department of Corrections telemedicine project. I was a member of the team that designed and implemented the first "true" telemedicine application for Strong Memorial Hospital. Jeannie L. Christensen - Page 4 of 81 Capstone Thesis It consists of an outlined discussion as presented on the Table of Contents and the networking design proposal to implement a telemedicine project. The paper also investigated some other telemedicine applications at the University of Rochester Medical Center that can be implemented in the future. We tried to follow a rigid timeline...

‣ Non-adherence to telemedicine interventions for drug users: systematic review

Moreira,Taís de Campos; Signor,Luciana; Figueiró,Luciana Rizzieri; Fernandes,Simone; Bortolon,Cassandra Borges; Benchaya,Mariana Canellas; Ferigolo,Maristela; Barros,Helena MT
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 Português
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OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably...

‣ A pilot study for the integration of cytometry reports in digital cytology telemedicine applications

Giansanti,Daniele; Cerroni,Fabio; Amodeo,Rachele; Filoni,Marco; Giovagnoli,Maria Rosaria
Fonte: Istituto Superiore di Sanità Publicador: Istituto Superiore di Sanità
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2010 Português
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Up to date, tele-pathology in the three different forms of application, "dynamic", "static" and "virtual microscopy" has been mainly based on tele-hystology remote consulting. Today the diffusion of specialized WAN connections is guiding the research of new applications of tele-pathology. A specific analysis has been conducted, focused on digital cytology, in the biomedical laboratory of Sant'Andrea Hospital to investigate the technologies potentially useful to integrate in the LAN/WAN for telemedicine applications. Among the possible tools useful to be integrated in the LAN/WAN for telemedicine applications, the cytometry equipment available in the technical unity of cytometry has been considered important. The study finally provides a proposal for a tele-consulting architecture for the integration of cytometry reports both in the hospital LAN and the WAN for possible cooperative diagnosis and second opinion support.